Prognosis

Prognosis is based on disease status at diagnosis, treatment response and adherence, and the patient’s life expectancy. Most people who adhere, and respond well, to treatment can expect to maintain a functional level of vision for the remainder of their lives.[106]

However, primary open-angle glaucoma is slowly progressive and may remain asymptomatic for extended periods. This may result in many patients remaining undiagnosed (>90% in low- and middle-income countries, compared with about 50% in high-income countries).[1][13]​​​ Compromised peripheral vision often does not become apparent until there is considerable loss of optic nerve fibers.[107]​ If untreated, glaucoma can eventually lead to blindness.

In a retrospective population-based cohort study of US adults diagnosed with open-angle glaucoma, the probability of glaucoma-related blindness in one or both eyes over a 20-year follow-up period was 13.5%.[108] One European chart review reported 10-year cumulative incidences of open-angle glaucoma-related blindness in at least one eye or bilaterally of 26.5% and 5.5%, respectively.[109] Comparable figures at 20 years were 38.1% and 13.5%.

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